Amanda Lyn Woolnough, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

415 Sherman St
Watertown, NY 13601-3920

Phone

(315) 221-4881

NPI assigned

Apr 26, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Amanda Lyn Shultz Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dietitians of Northern New York PLLCGroup PAC ID 8022497981, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dietitians of Northern New York, PLLC.

  dba Dietitians of Northern New York

  • Registered Dietitian
  • Watertown, NY
  • NPI 1316515208

  Dietitian, Registered

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1760126627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 MOULTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012035",
            "telephone_number": "315-222-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 SHERMAN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013920",
            "telephone_number": "315-221-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLNOUGH",
        "first_name": "AMANDA",
        "middle_name": "LYN",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SHULTZ",
            "middle_name": "LYN",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Whitney W Witter, MSW
• Krista Wohnsiedler, COTA
• Fonda Syche Wolf, P.T.
• Leslie Nichole Womack-Young, FNP-C
• Diane Marie Wood, PT
• Emily Laura Worden
• Tammi Worden
• Jaime Worrell
• Brandi L Wright
• Katie Elissa Wright, LMSW

• Registered Dietitian in Watertown, NY
• Providers in Watertown, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.